Key result
Among patients undergoing isolated CABG with an off-pump-first strategy, in-hospital death rates were 0% in octogenarians (≥80 years) and 0.5% in younger patients (<80 years).
Why the study?
Although off-pump coronary artery bypass provides promising results in octogenarians when complete revascularization is achieved, it requires significant experience, prompting investigation of outcomes with an off-pump-first strategy.
Does off-pump coronary artery bypass grafting provide safe and effective early and long-term outcomes in octogenarians compared to younger patients?
Cohort (n=707)
Does off-pump coronary artery bypass grafting provide safe and effective early and long-term outcomes in octogenarians compared to younger patients?
An off-pump-first strategy for coronary artery bypass grafting is safe and effective for octogenarians, yielding excellent peri-operative outcomes and long-term survival.
Supports off-pump CABG safety in octogenarians; leaves open need for randomized comparisons.
Background and aim: Ischemic heart disease is the leading cause of death around the world. Coronary artery bypass grafting offers efficient surgical revascularization for ischemic disease. Both on- or off-pump coronary artery bypass methods provide promising results to octogenarians, once complete vascularization is achieved. However, off-pump bypass requires a certain level of experience to achieve sufficient results. We have applied an off-pump coronary artery bypass-first strategy to all generations since 2008. This study investigated early and long-term results of surgical revascularization for octogenarians by a team with an off-pump-first strategy. Methods: All cases of isolated coronary artery bypass grafting performed since 2008 were identified and divided into a young group (age <80 years) and an old group (age >=80 years). Peri-operative results were investigated retrospectively in both groups and long-term results for the old group were assessed. Results: Among the 707 patients, 97% underwent off-pump bypass, and 94 cases were classified to the old group. Distal anastomoses and ventilator time were identical between groups (young vs. old: 3.3 vs. 3.2; 3.7 h vs. 3.7 h). In-hospital death rates were 0.5% and 0% in the young and old groups, respectively. With a mean follow-up of 1318 days, actual 1-, 3-, and 5-year survival rates for octogenarians were 92.1%, 81.2% and 68.3%, respectively. Nearly half of the patients reached their nineties, which was close to the life expectancy of the national general octogenarian. Conclusions: An experienced team with an off-pump-first strategy could provide valid therapeutic options for octogenarians.
No takes yet. Share an insight, caveat, or question.
Kitamura et al. (2021) conducted a cohort in Ischemic heart disease (n=707). Age ≥80 years (octogenarians) vs. Age <80 years was evaluated on In-hospital death rate. Among patients undergoing isolated CABG with an off-pump-first strategy, in-hospital death rates were 0% in octogenarians (≥80 years) and 0.5% in younger patients (<80 years).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: